CAJ | 학술논문

目的：检测青海地区子痫前期患者可溶性人类白细胞相关抗原G（ sHLA-G）蛋白水平及脐动脉血流动力学指标，分析其间的相关性。方法选取2014年9—12月在青海大学附属医院分娩的产妇90例，其中正常妊娠妇女30例，轻度子痫前期患者26例，重度子痫前期患者34例。于临产前抽取3组研究对象静脉血，采用酶联免疫吸附试验（ELISA）检测sHLA-G水平；并采用多普勒超声诊断仪，检测脐动脉血流搏动指数（PI）、脐动脉血流阻力指数（RI）以及脐动脉收缩末期最大血流速度与舒张末期最大血流速度的比值（S/D）。结果3组血清sHLA-G水平、PI、RI及S/D比较，差异均有统计学意义（ P<0.001）；其中轻度子痫组和重度子痫组血清sHLA-G水平低于正常妊娠组，PI、RI及S/D均高于正常妊娠组；重度子痫组血清sHLA-G水平低于轻度子痫组，PI、RI及S/D均高于轻度子痫组，差异有统计学意义（P<0.05）。3组尿蛋白值分布比较，差异有统计学意义（U=80.416，P<0.05）。相关分析结果显示，子痫前期患者尿蛋白与血清sHLA-G呈负相关（ r=-0.873，P<0.05），sHLA-G与S/D呈负相关（r=-0.784，P<0.05），sHLA-G与RI呈负相关（r=-0.522，P<0.05），sHLA-G与PI呈负相关（r=-0.638，P<0.05）。结论 sHLA -G 蛋白水平和脐动脉血流动力学指标与子痫前期患者病情严重程度有关，且sHLA-G蛋白水平与脐动脉血流动力学存在相关性，测定SHLA-G和脐动脉血流动力学指标可预测胎儿宫内生长环境及出生结局。
목적：검측청해지구자간전기환자가용성인류백세포상관항원G（ sHLA-G）단백수평급제동맥혈류동역학지표，분석기간적상관성。방법선취2014년9—12월재청해대학부속의원분면적산부90례，기중정상임신부녀30례，경도자간전기환자26례，중도자간전기환자34례。우임산전추취3조연구대상정맥혈，채용매련면역흡부시험（ELISA）검측sHLA-G수평；병채용다보륵초성진단의，검측제동맥혈류박동지수（PI）、제동맥혈류조력지수（RI）이급제동맥수축말기최대혈류속도여서장말기최대혈류속도적비치（S/D）。결과3조혈청sHLA-G수평、PI、RI급S/D비교，차이균유통계학의의（ P<0.001）；기중경도자간조화중도자간조혈청sHLA-G수평저우정상임신조，PI、RI급S/D균고우정상임신조；중도자간조혈청sHLA-G수평저우경도자간조，PI、RI급S/D균고우경도자간조，차이유통계학의의（P<0.05）。3조뇨단백치분포비교，차이유통계학의의（U=80.416，P<0.05）。상관분석결과현시，자간전기환자뇨단백여혈청sHLA-G정부상관（ r=-0.873，P<0.05），sHLA-G여S/D정부상관（r=-0.784，P<0.05），sHLA-G여RI정부상관（r=-0.522，P<0.05），sHLA-G여PI정부상관（r=-0.638，P<0.05）。결론 sHLA -G 단백수평화제동맥혈류동역학지표여자간전기환자병정엄중정도유관，차sHLA-G단백수평여제동맥혈류동역학존재상관성，측정SHLA-G화제동맥혈류동역학지표가예측태인궁내생장배경급출생결국。
Objective To investigate the correlation between umbilical artery blood flow changes and serum level of sHLA-G in patients with preeclampsia in Qinghai Province. Methods We enrolled 90 pregnant women who underwent childbirth in the Affiliated Hospital of Qinghai University from September to December 2014. Among them,30 subjects were normal in childbirth,26 subjects were with mild preeclampsia and 34 were with severe preeclampsia. Before delivery,venous blood was sampled from the three groups of subjects. Then ELISA method was employed to test serum level of sHLA-G,and doppler ultrasonography was used to detect PI,RI and S/D. Results The three groups were significantly different(P<0. 001) in serum level of sHLA-G,PI,RI and S/D;the mild preeclampsia group and the severe preeclampsia group were lower( P<0. 05)in serum level of sHLA - G and higher(P <0. 05)in PI,RI and S/D than normal childbirth group;the severe preeclampsia group was lower(P<0. 05)in serum level of sHLA-G and higher(P<0. 05)in PI,RI and S/D than the mild preeclampsia. The three groups were significantly different in the distribution of urine protein(U=80. 416,P<0. 05). The correlation analysis showed that,among the patients with preeclampsia,the urine protein was negatively correlated with serum level of sHLA-G(r= -0. 873,P<0. 05),serum level of sHLA-G was negatively correlated with S/D(r= -0. 784,P<0. 05),serum level of sHLA-G was negatively correlated with RI(r= -0. 522,P<0. 05),and serum level of sHLA-G was negatively correlated with PI(r= -0. 638,P<0. 05). Conclusion The serum level of sHLA-G and the hemodynamic change of umbilical artery is correlated with severity degree of preeclampsia,and serum level of sHLA-G is correlated with the hemodynamic change of umbilical artery,which helps to predict the intrauterine environment for fetus and childbirth outcome.